| Kenaitze Indian Tribe | |
|
508 Upland St Kenai AK 99611-8026 | |
| (907) 335-7550 | |
| (888) 491-3360 |
| Full Name | Kenaitze Indian Tribe |
|---|---|
| Speciality | Clinic/Center |
| Location | 508 Upland St, Kenai, Alaska |
| Authorized Official Name and Position | Greg Burnett (FINANCE DIRECTOR) |
| Authorized Official Contact | 9073357200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenaitze Indian Tribe Po Box 988 Kenai AK 99611-0988 Ph: (907) 335-7550 | Kenaitze Indian Tribe 508 Upland St Kenai AK 99611-8026 Ph: (907) 335-7550 |
| NPI Number | 1932114600 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/13/2025 |
| Medicare PECOS PAC ID | 4082506225 |
|---|---|
| Medicare Enrollment ID | O20040325000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932114600 | NPI | - | NPPES |
| CL9243 | Medicaid | AK |
| Provider Name | Fridrik Gudmundsson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831531037 PECOS PAC ID: 9335383819 Enrollment ID: I20130924000297 |
| Provider Name | Dolores Van Bourgondien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788390 PECOS PAC ID: 9032332275 Enrollment ID: I20190610000219 |
| Provider Name | David Seramur |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437566635 PECOS PAC ID: 4082046297 Enrollment ID: I20191108001511 |
| Provider Name | Wayne Russell Millar |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821172594 PECOS PAC ID: 7416366232 Enrollment ID: I20210507000987 |
| Provider Name | Mary M Bassir |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1700449048 PECOS PAC ID: 3870986979 Enrollment ID: I20220214001813 |
| Provider Name | Stephan Becker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063678795 PECOS PAC ID: 2062660921 Enrollment ID: I20220509002364 |
| Provider Name | Lisa Mapuranga |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972696722 PECOS PAC ID: 5698098846 Enrollment ID: I20221116002885 |
| Provider Name | Kristen Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629679782 PECOS PAC ID: 6608275284 Enrollment ID: I20221205002891 |
| Provider Name | Rebecca Strong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356990055 PECOS PAC ID: 3870954902 Enrollment ID: I20230804001647 |
| Provider Name | Chelsea Eisenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215559919 PECOS PAC ID: 6901253608 Enrollment ID: I20240212003667 |
| Provider Name | Craig Ward |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1043435118 PECOS PAC ID: 1153762828 Enrollment ID: I20240513000714 |
| Provider Name | Shana Mickenham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972089738 PECOS PAC ID: 5193166767 Enrollment ID: I20240514001286 |
| Provider Name | Joseph J. Cannava |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821180456 PECOS PAC ID: 3577005289 Enrollment ID: I20240610003092 |
| Provider Name | Colleen Robertia |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598328841 PECOS PAC ID: 3375086705 Enrollment ID: I20240613003144 |
| Provider Name | Kimi Hmar Zook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255489852 PECOS PAC ID: 1850839028 Enrollment ID: I20240819003516 |
| Provider Name | Deborah Chambless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962809061 PECOS PAC ID: 7416221593 Enrollment ID: I20241106000002 |
| Provider Name | David Andrew Plaisance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902325699 PECOS PAC ID: 5698015220 Enrollment ID: I20241111002962 |
| Provider Name | Zachary Benning |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063149367 PECOS PAC ID: 1850777335 Enrollment ID: I20250219001704 |
| Provider Name | Jessica E Duke |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1639775315 PECOS PAC ID: 3476075110 Enrollment ID: I20250321002380 |
| Provider Name | Cassie Weaver |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184290884 PECOS PAC ID: 7214311208 Enrollment ID: I20250401001971 |
| Provider Name | Molly Hamilton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346860848 PECOS PAC ID: 4082038468 Enrollment ID: I20250416003404 |
| Provider Name | Jennifer Rea Kuker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194375758 PECOS PAC ID: 6901231547 Enrollment ID: I20250430002771 |
Medical Network Of Alaska, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10543 Kenai Spur Hwy, Kenai, AK 99611 Phone: 907-357-9590 Fax: 907-357-9593 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 416 Frontage Rd # 400, Kenai, AK 99611 Phone: 509-222-1275 Fax: 509-491-3031 | |
Independence Healthcare Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Trading Bay Rd Ste 8, Kenai, AK 99611 Phone: 907-283-4633 Fax: 907-262-0832 | |
Redoubt Medical Group Llc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 416 Frontage Rd Ste 200, Kenai, AK 99611 Phone: 907-283-6030 Fax: 907-283-3194 | |
Kenai Medical Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Frontage Rd, Ste 123, Kenai, AK 99611 Phone: 907-283-4611 Fax: 907-283-3992 | |
Kenneth S Hahn Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11472 Kenai Spur Hwy Ste 2, Kenai, AK 99611 Phone: 907-283-6030 Fax: 907-283-3194 | |
Peninsula Community Health Services Of Alaska, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 805 Frontage Rd, Suite 130, Kenai, AK 99611 Phone: 907-283-3600 Fax: 907-283-3601 |